Mary Denise Escobar

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95014659 Issued in CA

Practice address

1775 Modoc Ave
Tulare, CA 93274-9068

Phone

(559) 471-9294

NPI assigned

Jun 5, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.denise.escobar@410916565811204.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advanced Care Medical Group Inc

  • Family Medicine Physician
  • Visalia, CA
  • NPI 1295114965

  Single Specialty

  Medicare reassignment NPD
• Kaweah Delta Health Care District

  • Multi-Specialty Clinic/Center
  • Visalia, CA
  • NPI 1326704529

  Single Specialty

  Medicare reassignment NPD
• Kaweah Delta Health Care District

  • Community/Behavioral Health Agency
  • Visalia, CA
  • NPI 1447016050
  NPD
• Kaweah Delta Health Care District

  • Multi-Specialty Clinic/Center
  • Visalia, CA
  • NPI 1740688894
  NPD
• Kaweah Delta Health Care District

  • Rural Health Clinic/Center
  • Exeter, CA
  • NPI 1043272172
  NPD (past)
• Kaweah Delta Health Care District

  • General Acute Care Hospital
  • Visalia, CA
  • NPI 1588663769
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1083238976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7475",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932907475",
            "telephone_number": "559-635-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1775 MODOC AVE",
            "city": "TULARE",
            "state": "CA",
            "postal_code": "932749068",
            "telephone_number": "559-471-9294"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1775 Modoc Ave",
            "address_purpose": "LOCATION",
            "city": "Tulare",
            "state": "CA",
            "postal_code": "932749068",
            "country_code": "US",
            "telephone_number": "559-471-9294",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESCOBAR",
        "first_name": "MARY",
        "middle_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95014659",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95014659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "none",
            "affiliation": "N",
            "address_1": "1775 Modoc Ave",
            "city": "Tulare",
            "state": "CA",
            "country_code": "US",
            "postal_code": "932749068",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katherine Enriquez
• Entabi MD Inc
• Fateh Entabi, MD
• Erik Sean Bidinger-Boggess
• Niklas Eriksson
• Eva Guadalupe Escobedo, PHARMD
• Bakri Eskif Dabbagh, MD
• Brooke Janelle Espindola
• Victor Espinoza Saavedra, FNP
• Franchesca Corrine Espinoza

• Family Nurse Practitioner in Tulare, CA
• Providers in Tulare, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.